PATHOLOGY
PATIENT SYMPTOMS
DIAGNOSIS
IMAGING
TREATMENT
100
Most common causes of Croup
What is Parainfluenza, RSV, Adenovirus
100
9 month old with nasal discharge and congestion past 3 days presenting to the ED with fever of 101.5, barking cough, increased respiratory efforts.
PE significant for mild subcostal retractions and inspiratory stridor at rest
What is croup?
100
4 year old with congestion, rhinorrhea, dry cough for past 3 days and diarrhea x2 days
PE: erythematous posterior oropharynx, clear nasal discharge.
Vitals stable
Diagnosis?
What is: viral/ common cold
100
Diagnositic imaging of croup
What is clinical, no imagining necessary?
100
Treatment for pharyngitis with CENTOR score >4
What is Amoxicillin or Penicillin
200
Bacterial isolates of bacterial tracheitis
What is S Aureus, S pneumonia, GAS, Moraxella
200
Clinical features of epiglottis
What is: respiratory distress, anxiety, tripod or sniffing position, stridor, drooling, change in voice, toxic appearance
PE red swollen epiglottitis
200
CENTOR SCORING
What is:
Cough (absent) +1
Exudates +1
Nodes +1
Temp >38 C +1
OR age <14 +1 OR age >44 -1
200
diagnostic imagining for retropharyngeal abscess
What is lateral neck radiograph an/or CT with contrast of neck.
200
Treatment for bacterial tracheitis
300
Microbiology for retropharyngeal abscess
300
12 year old with rapid onset fever of 104.5, appears anxious, difficulty swallowing for 3 days, neck pain, decreased oral intake.
Physical exam noticeable for saliva pooling, enlarged anterior cervical LN
What is retropharyngeal abscess
300
Test of choice for stable patient with fever, stiff neck, dysphagia and increased prevertebral space on neck xray
What is CT scan with IV contrast
300
What is bacterial tracheitis or croup
300
Treatment for patient with suspected suspected retropharyngeal infection and signs of severe airway obstruction
What is: secure airway followed by surgical incision and drainage
400
anterior and posterior boundaries of retropharyngeal abscess
what is anterior boundary is middle layer of deep cervical fascia
posterior boundary is deep layer of deep cervical fascia
400
Child with respiratory distress with acute onset of fever, inspiratory stridor, pain with swallowing and hoarseness of voice
400
Diagnosis for epiglottitis
What is clinical
If no other diagnosis established & unable to visualize the epiglottis direct visualization with fiberoptic nasopharyngoscopy or indirect laryngoscopy preferred OR soft tissue lateral neck radiograph
400
thumb print sign on xray
epiglottitis
400
Treatment for mild croup
What is single dose of oral dexamentahsome (0.15mg-0.6mg/kg)
500
Infectious etiology of epiglottis besides Hib
What is:
S. Aeurus ( MRSA), S. Pneumo, Strep pyO, Nisseria, Pausterlla
500
Unilateral mucupurelent nasal dischage past week with mouth breathing in 2 year old
What is foreign body
500
Definitive diagnosis of bacterial tracheitis
What is direct visualization of the air way via laryngoscopy and tracheobronchoscopy.
500
soft tissue lateral neck radiograph in patient with epiglottitis findings
thickened epiglottis or aryepiglottic folds
500
Treatment for moderate to severe croup
What is dexamethasone 0.6mg/kg
What is racemic epinephrine
What is supportive care: oxygen or humidified ai, antipyretics and encourage fluid intake